Acne (part 2): Natural remedies, light and oral meds

In the May 2018 issue of Heartfelt I began a series on acne vulgaris, in which I discussed general treatment approaches: diet, lifestyle, washing practices and topical medication.

In this article I’ll address light therapy and oral medications (other than isotretinoin). Remember that treatment is implemented in a stepwise fashion depending on the severity of the condition. It may take a full one-to-two months of trying something before the peak benefit is noticed.

In addition to my first article’s more conservative measures, you might also consider any number of other approaches that have less scientific publicity to merit them. For example, an online search for “natural treatment for acne” yielded the following hits that, among others, you could consider:

Mayo Clinic even supports the trial of some natural remedies, including tea tree oil, bovine cartilage, zinc and Brewer’s yeast.

With that said, let’s continue to explore standard (and some non-standard but promising) treatment options.*

Light therapy uses blue, red, or full (broad) spectrum light, or lasers. According to medical literature, the jury is still out as to the effectiveness of light therapy. With that said, at the time when this article was on its way to publication, a CHM staffer personally attested to the effectiveness of a relatively new variation of light therapy known as Photopneumatic Pore-Cleansing (PPx). During this treatment, the PPx instrument is placed directly over the acne lesion, where it applies a gentle vacuum to draw out the contents of the comedone, pustule, or nodule; temporarily stretches and thins the epidermis; then applies broadband light which converts to heat. The treatment appears relatively quick and painless and sounds logical (though, again, it’s too early to attest from mainstream medical journals as to its effectiveness). Nevertheless, given the strong endorsement from a fellow staffer and the relative safety of the treatment, consult a dermatologist if you think you might be a good candidate for light therapy.

Oral medications are typically tried next, led by antibiotics. If necessary this is followed by (believe it or not) a hypertension medication, and finally a toxic but effective derivative of vitamin A.

Common antibiotics including tetracycline, doxycycline, or erythromycin, depending on the age and gender of the patient (some, particularly the tetracyclines, are contraindicated in young children and pregnant women because they can cause birth defects as well as discoloration of the bones and teeth).

Spironolactone (Aldactone is the brand name), a “potassium-sparing” high blood pressure medication, has also been effective over many years. Spironolactone has anti-androgen properties, which seem especially effective for adult, hormonally-caused acne. “Anti-androgen” means opposing excess male hormone. Androgens are not unique to men, though. Women have them, too. Like tetracyclines, spironolactone is also contraindicated in women trying to conceive or who are nursing or pregnant.

Finally, for severe acne that is refractory to all other treatment measures, there is isotretinoin (brand names include Accutane, Amnesteem, Claravis, Sotret), an oral vitamin A derivative. I will discuss isotretinoin in the final installment of this series.

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